自从1760年首次被描述以来,急性A型主动脉夹层在其管理中造成了困难。最近的COVID-19大流行表明,这种情况可能会出现肺外表现,最近的报道表明,主动脉夹层可能是其中之一,因为它具有共同的病理生理学,也就是说,过度炎症综合征.在COVID-19阳性患者的情况下进行体外循环的心脏手术具有术后呼吸衰竭的高风险。虽然绝大多数人接受A型主动脉夹层的治疗需要紧急手术和中央主动脉治疗,有一些报道主张推迟手术。在这种情况下,主动脉破裂的风险必须与推迟紧急手术的可能益处相平衡.我们介绍了一例急性A型夹层合并COVID-19相关支气管肺炎的病例,在延迟手术6天后成功治疗。
Ever since it was first described in 1760, acute type A aortic dissection has created difficulties in its management. The recent COVID-19 pandemic revealed that extrapulmonary manifestations of this condition may occur, and recent reports suggested that aortic dissection may be amongst them since it shares a common physiopathology, that is, hyper-inflammatory syndrome. Cardiac surgery with cardiopulmonary bypass in the setting of COVID-19-positive patients carries a high risk of postoperative respiratory failure. While the vast majority accept that management of type A aortic dissection requires urgent surgery and central aortic therapy, there are some reports that advocate for delaying surgery. In this situation, the risk of aortic rupture must be balanced with the possible benefits of delaying urgent surgery. We present a case of acute type A dissection with COVID-19-associated bronchopneumonia successfully managed after delaying surgery for 6 days.